U.S. patent number 4,605,990 [Application Number 06/653,717] was granted by the patent office on 1986-08-12 for surgical clip-on light pipe illumination assembly.
Invention is credited to Franklin G. Reick, Joseph R. Wilder.
United States Patent |
4,605,990 |
Wilder , et al. |
August 12, 1986 |
Surgical clip-on light pipe illumination assembly
Abstract
A disposable surgical clip-on light pipe illumination assembly
constituted by a manually-operated clamp adapted to clip onto an
abdominal or other tissue wall surrouding a surgical site. The
clamp is provided with a holder to retain a short, flexible light
pipe at a position at which the front section of the pipe which
terminates in an optical outlet projects into the surgical site.
The rear end of the pipe terminates in an optical inlet coupled to
a light source whereby light transmitted through the pipe is
discharged from its optical outlet into the site. The front section
of the pipe is sheathed in a bendable sleeve having dead soft
characteristics, thereby making it possible for the surgeon, by
bending the sleeve, to orient the light outlet to direct the light
emanating therefrom toward a desired region of the surgical
site.
Inventors: |
Wilder; Joseph R. (New York,
NY), Reick; Franklin G. (Westwood, NJ) |
Family
ID: |
27086697 |
Appl.
No.: |
06/653,717 |
Filed: |
September 24, 1984 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
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612149 |
Jan 21, 1984 |
4562832 |
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Current U.S.
Class: |
362/581; 24/507;
600/218; 600/245; 600/249 |
Current CPC
Class: |
A61B
1/32 (20130101); A61B 17/02 (20130101); A61B
90/30 (20160201); A61B 1/00117 (20130101); A61B
2090/306 (20160201); Y10T 24/44444 (20150115) |
Current International
Class: |
A61B
17/02 (20060101); A61B 1/32 (20060101); F21V
008/00 () |
Field of
Search: |
;362/32
;24/457,489,499,507 ;128/18,20,303.1 ;138/DIG.8 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Wolfe; Willis R.
Attorney, Agent or Firm: Ebert; Michael
Parent Case Text
RELATED APPLICATION
This application is a continuation-in-part of our copending patent
application Ser. No. 612,149, filed Jan. 21, 1984, entitled
"Medical Instrument and Light Pipe Illumination Assembly," now U.S.
Pat. No. 4,562,832, whose entire disclosure is incorporated herein
by reference.
Claims
We claim:
1. A light pipe illumination assembly to illuminate a work site,
said assembly comprising:
A. a light pipe having an optical outlet at its front end and an
optical inlet at its rear end, said rear end having means to couple
the pipe to a light source;
B. detachable means to anchor said pipe adjacent the work site at a
position in which the front section cantilevers form the anchor
means into the site; and
C. a bendable sleeve surrounding the front section having dead soft
characteristics to render the front section orientable.
2. A surgical clip-on light pipe illumination assembly
comprising:
A. a manually-operated clamp adapted to clip onto an abdominal or
other tissue wall surrounding a surgical site without damage
thereto, said clamp being provided with a light pipe holder;
and
B. a short, flexible light pipe formed of a plastic monofilament
having a high refractive index surrounded by a cladding tube of
lower refractive index and having an optical inlet at its rear end
and an optical outlet at its front end, said pipe being retained by
the holder at a position at which the front section of the pipe
whose front end forms said optical outlet cantilevers from the
holder into the surgical site, said front section being ensheathed
in a bendable sleeve having dead soft characteristics to orient
said optical outlet to adjust the direction of the light beam and
to maintain it at its adjusted orientation, the optical inlet of
the pipe being coupled to a remote light source whereby the light
transmitted through the pipe is discharged from the optical outlet
to produce a light beam which is directable into the surgical site
to illuminate any region of interest.
3. An assembly as set forth in claim 2, wherein said holder is
coupled to the clamp through a universal joint.
4. An assembly as set forth in claim 2, wherein said sleeve is
formed of a tube of flexible foam plastic material having at least
one wire of dead soft material embedded therein.
5. An assembly as set forth in claim 4, wherein said sleeve has
embedded therein an array of longitudinally-extending wires.
6. An assembly as set forth in claim 2, wherein said clamp is
formed by a pair of pieces each having a handle at one end and a
jaw at the other end, the pieces being pivotally connected and
spring-biased, whereby the jaws normally engage each other and are
separated by pressing the handles together.
7. An assembly as set forth in claim 6, wherein said handles are in
loop form, whereby the pipe may be extended through the loop
openings and the handles also function as the holder.
Description
BACKGROUND OF INVENTION
Field of Invention
This invention relates generally to devices usable in surgical
procedures to illuminate a region of interest, and more
particularly to a disposable clip-on light pipe illumination
assembly in which the front section of the light pipe which
projects into the surgical site is orientable to illuminate any
region of interest to the surgeon.
Though the invention will be described mainly in the context of
surgical applications, it is to be understood that the invention is
not limited thereto, for an assembly in accordance with the
invention is capable of transmitting light of high intensity by
means of an orientable light pipe to remote or inaccessible work
sites which are difficult to illuminate by conventional
techniques.
The professional concern of doctors and surgeons is with body
cavities and surgical sites which, unless clearly visible, cannot
be properly diagnosed or treated. Existing techniques for
illuminating such regions are often inadequate and unsafe, for they
either do not succeed in supplying sufficient illumination or they
generate excessive amounts of heat which may injure human tissue as
well as cause discomfort to the observer. In some instances,
commercially available illuminators interfere with medical
procedures and also constitute a hazard to both patient and
doctor.
The standard operating room illuminator is constituted by batteries
of explosion-proof spot lamps and floor lamps, which are capable of
being shifted or aimed to suit particular procedures. Such
illuminators, which are quite costly, are not only cumbersome, but
they fail to afford adequate illumination for deep cavities, in
that the light sources are above or behind the surgeons or other
operating personnel, whose heads, hands and instruments, as they
shift position, often block the light rays.
In recent years, attempts have been made to use long, flexible
fiber optics light guides in medical and related applications. Such
guides are advantageous in that they furnish "cold light" and
segregate the heavy and bulky assembly of lamp, condenser and
cooling system from the point of observation. Also, with the
development of flexible fiber optic guides with fused ends and
plastic casings, sterilization of the instrument is possible.
In its preferred form, a clip-on assembly in accordance with the
present invention includes a flexible light guide in a
monofilament-core pipe format. This represents a particular species
of an optical fiber. It is important, therefore, that the
distinctions which exist between a conventional multi-fiber optical
light pipe or cable and a light pipe having a monofilament-core be
clearly understood.
An optical fiber is a dielectric waveguide structure which
functions by internal reflection to confine and guide light. It
consists of an inner dielectric material, called the core,
surrounded by another dielectric material having a smaller
refractive index, referred to as the cladding. Currently, all
optical fibers in general use have a cylindrical circular cross
section.
The amount of light flux which an optical fiber is capable of
conveying depends on the cross-sectional diameter of the core; and
when there is a need to transmit large amounts of light at a
constant level for purposes of illumination, rather than a
modulated light signal for purposes of communication, use is
usually made of a bunched cluster of optical fibers, each conveying
a small amount of light.
Since the present invention is concerned primarily with
illumination, it employs a light guide in the form of a flexible
pipe having a monofilament-core of large diameter surrounded by a
cladding tube. The monofilament core serves the same function as a
cluster of small diameter cores, but operates with far greater
optical efficiency to transmit large amounts of light with minimal
transmission losses. It is also more bendable than conventional
multi-filament core light pipes.
Fiber optic guides may be used as auxiliary illuminators for close
diagnostic and surgical operations, as illuminators for direct or
indirect ophthalmoscopes, and as specially shaped illumination
accessories to classical-designed cytoscopes, proctoscopes,
retractors, and various forms of medical, surgical and dental
tools.
Despite the obvious advantages of fiber optics for cold-light
illumination, their use in the surgical, medical and dental fields
has been relatively limited. The reason for such limited use does
not lie in any inherent theoretical deficiency, but in the fact
that with existing technology, the three basic components of the
fiber optics system, when brought together, do not afford
sufficient illumination in those situations calling for large
amounts of cold light which can be readily directed to selected
regions of a body cavity.
In our copending patent application, above-identified, a medical
instrument and light pipe assembly is disclosed which makes use of
a flexible plastic light pipe whose monofilament core is surrounded
by a cladding tube, the light pipe being joined to an instrument
such as a surgical retractor which, when put to use, assumes a
position in which its operative blade lies adjacent to the field of
interest, such as a body cavity or surgical site.
The optical inlet at the rear end of the light pipe is coupled to a
light source whereby light transmitted by the pipe is discharged
from an optical outlet at the front section of the pipe which is
adjacent to the blade of the retractor. The front section of the
pipe is sheathed in a bendable neck having dead soft
characteristics whereby the user, by bending the neck, may so
orient the optical outlet as to direct the light toward a desired
region of the surgical site.
In the assembly disclosed in our copending application, the
specially-designed molded plastic retractor included in the
assembly is provided with clips or other routing means to link the
retractor to the flexible light pipe; hence standard retractors
cannot be used for this purpose.
Most hospital facilities carry a large inventory of standard
retractors of different types, and these are often put to use in
surgical procedures. Though distinct advantages may be gained by
replacing standard retractors with the specially-designed
retractors disclosed in our copending application, which are
combined with orientable light pipe illuminators, practical
considerations dictate the need for an independent device capable
of exploiting these orientable illuminators for use in conjunction
with standard surgical retractors.
In this way, surgeons can continue to carry out procedures with
available retractors and other conventional instruments and yet
take advantage of the enhanced and unobstructed illumination
afforded by spilling light directly onto the surgical site, rather
than drawing light from overhead sources which may be more or less
occluded by personnel working in the vicinity of the surgical
site.
The prior art patent of greatest interest is the Reick-Wilder Pat.
No. 3,641,332, which discloses a flexible light pipe constituted by
a monofilament core of resinous material of large diameter, such as
methyl methacrylate contained within a cladding tube formed of FEP
(Teflon), the core being separated from the tube by a film of air.
The core has a relatively high index of refraction capable of
transmitting light by internal reflectors, whereas the cladding
tube has a relatively low refractive index.
SUMMARY OF INVENTION
In view of the foregoing, the main object of this invention is to
provide a light pipe illumination assembly adapted to clip onto an
abdominal or other tissue wall surrounding a surgical site, the
front section of the pipe being orientable to direct light toward a
region of interest.
While the assembly, when used in surgery, is clipped onto a tissue
wall, the same assembly, when used in other applications requiring
direct illumination, may be clipped onto whatever wall or other
stable member is available at the work site.
More specifically, it is an object of the invention to provide an
assembly composed of a manually-operated plastic clamp and a short
length of light pipe made of synthetic plastic material whereby the
entire assembly is inexpensive and is disposable after a single
use, thereby dispensing with the need to clean and resterilize the
assembly.
Briefly stated, these objects are attained in disposable surgical
clip-on light pipe illumination assembly constituted by a
manually-operated clamp adapted to clip onto an abdominal or other
tissue wall surrounding a surgical site. The clamp is provided with
a holder to retain a short, flexible light pipe at a position at
which the front section of the pipe which terminates in an optical
outlet projects into the surgical site. The rear end of the pipe
terminates in an optical inlet coupled to a light source whereby
light transmitted through the pipe is discharged from its optical
outlet into the site. The front section of the pipe is sheathed in
a bendable sleeve having dead soft characteristics, thereby making
it possible for the surgeon, by bending the sleeve, to orient the
light outlet to direct the light emanating therefrom toward a
desired region of the surgical site.
OUTLINE OF DRAWINGS
For a better understanding of the invention as well as other
objects and further features thereof, reference is made to the
following detailed description to be read in conjunction with the
accompanying drawings, wherein:
FIG. 1 is a perspective view of a clip-on assembly in accordance
with the invention;
FIG. 2 is an end view of the clamp included in the assembly;
FIG. 3 is a side view of the clamp;
FIG. 4 is a top view of the clamp;
FIG. 5 is a longitudinal section taken through the front section of
the light pipe and the bendable sleeve surrounding the front
section to render it orientable;
FIG. 6 is a preferential view of the sleeve; and
FIG. 7 is another embodiment of a clamp for use in conjunction with
the light pipe.
DESCRIPTION OF INVENTION
Referring now to FIGS. 1 to 3, an assembly in accordance with the
invention is constituted by a light pipe to provide direct and
orientable illumination at a surgical site, joined to a
manually-operated clamp having a pair of complementary pieces,
generally designed by numeral 10, the clamp being formed entirely
of synthetic plastic material of good strength such as
polypropylene.
Each piece includes a loop-shaped handle 11 having a circular
opening, an intermediate trunnion 12 having an arcuate slot, and a
flat jaw 13 whose inner surface 14 is corrugated to prevent
slippage when the jaws are clamped onto tissue wall 17.
Received within the complementary arcuate slots of trunnion 12 is a
pivot tube 15 having end flanges 16 to prevent axial displacement
thereof, the pieces being swingable relative to each other so that
the jaws may be opened and closed. The pieces are held together by
a U-shaped spring 18 of resilient plastic material whose yoke is
seated on the pivot tube, the depending arms of the spring engaging
the flat outer surfaces of jaws 13 and terminating in detents which
snap into notches 19 in these outer surfaces. Spring 18 acts to
normally bias the jaws toward each other; but when the handles are
pressed together, the jaws swing apart to permit their engagement
with a tissue wall.
The clamp serves as an anchor for a flexible plastic light pipe of
short length, generally designated by numeral 20. The front section
of light pipe 20 is sheathed in a bendable tubular sleeve 21. The
sheathed front section is threaded through the loop openings of the
handles 11 of the clamp, as shown in FIG. 1, and projects therefrom
onto the surgical site. Thus the looped handle of the clamp also
functions as the holder for the light pipe, hence the diameter of
the loop openings must be appropriate to that of the ensheathed
front section of the light pipe.
The rear end of light pipe 20 forms an optical inlet and terminates
in an optical connector 22, preferably of plastic construction,
adapted to couple the short light pipe to a high-intensity light
source 23 by way of an extension line 20A. This line may be a long
light pipe of the same type as the short pipe 20 so that the light
source which is electrically powered is at a safe distance from the
operating table and beyond the sterile field. In practice, the
light source may be of the type disclosed in the above-identified
Reick-Wilder patent, whose entire disclosure is incorporated herein
by reference.
The bendable sleeve 21 may be of the type disclosed in our
copending application and be made of thin tubular material, such as
aluminum, which has dead soft characteristics and is altogether
without memory, so that when the sleeve is manually bent and then
released, it retains its deformed state without springing back. The
sleeve may be formed by a spiral of metal stripping. Hence when the
retractor and light pipe assemblies are in use at a surgical site,
as shown in FIG. 1, light from the source is transmitted through
the light pipe and projected from the optical outlet end thereof
into the surgical site. Since in the course of a surgical
procedure, the surgeon may wish to concentrate the light on a
particular region in the site, in order to do so, he has only to
bend the light director sleeve so as to orient the outlet end of
the pipe in the desired direction, the sleeve then acting in a
manner comparable to a goose neck. And this bending action of the
sleeve may be carried out repeatedly as other regions require
illumination in the course of a procedure.
A preferred form of sleeve 21 is shown in FIG. 6, where it will be
seen that the sleeve is formed of a tube of flexible foam plastic
material having embedded therein an array of
longitudinally-extending wires 24 of copper, lead or other metal
having dead soft characteristics. The advantage of a foam plastic
sleeve of this type is that the sleeve through which the front
section of the light pipe is telescoped is compressible and can be
dimensioned with respect to the loop handles of the clamp so as to
be compressed within the loops to ensure a stable coupling to the
clamp holder. As shown in FIG. 5, light pipe 20 has a plastic core
25 of high refractive index surrounded by a cladding tube 26 of
lower refractive index separated by a thin air film from the
core.
As pointed out in the above-identified Reick-Wilder patent, the
ideal light guide has a core of the highest possible refractive
index in combination with a cladding of the lowest possible
refractive index. Commercially-available light pipes, such as the
"CROFON" pipe made by DuPont, falls far short of this ideal, for
this pipe makes use of a polymethyl methylacrylate core in a
polyethylene cladding tube.
Polyethylene has a refractive index of 1.54, as compared to air,
whose index is 1.0. However, though air has the lowest possible
refractive index, air normally cannot serve as a cladding, for, if
unconfined, it is incapable of protecting the core from scratches
and contamination which degrade its quality. In the Reick-Wilder
light pipe, one still has a protective plastic outer tube (Teflon);
but it is the inner air film, except at those limited points where
the core makes physical contact with the tube, which acts
effectively as a cladding having the lowest possible refractive
index. At those points where the core touches the Teflon tube,
internal reflection will still take place, for Teflon has a
refractive index of about 1.34 which is lower than that of the core
and therefore functions as a cladding, though this cladding is less
effective than air.
Thus the light pipe 20 and core adjacent the surgical site act to
transmit light efficiently from the source to the optical outlet
and to spill the light onto the site. Since the front section of
the pipe is readily orientable and will maintain the bend imparted
thereto, the surgeon, as the need arises in the course of a
procedure, may reorient the front section to illuminate whatever
region of the site is of interest.
In some instances, it may be desirable to provide means on the
clamp to permit a gross adjustment of the light pipe so that it can
be quickly oriented in the desired direction and then further
oriented by bending the front section. To this end, as shown in
FIG. 7, the clamp has a universal joint 27 attached thereto
provided with a holder 28 to receive the front section of the light
pipe. The universal joint is in the form of a ball clamped between
a pair of resilient blades. In this way the surgeon can, by
adjustment of the joint, orient the front section of the light pipe
in the general direction of the region of interest and by bending
the front section orient the light beam more precisely.
While there has been shown and described a preferred embodiment of
CLIP-ON LIGHT PIPE ILLUMINATION ASSEMBLY in accordance with the
invention, it will be appreciated that many changes and
modifications may be made therein without, however, departing from
the essential spirit thereof.
Thus, instead of a universal joint attached to the clip-on clamp as
shown in FIG. 7 to provide a holder for the light pipe permitting
gross adjustment thereof, use may be made of a pipe holder having a
pipe-holding section and a snap-in section in the form of a round,
resilient plastic button which snaps into one of the circular
handle loops of the clamp shown in FIG. 2, whereby the button may
be turned within the loop to angularly shift the position of the
front section of the light pipe.
In dental applications, the clamp for the light pipe may be
designed to clip onto the teeth or lip of the patient adjacent the
work site, or it may be adapted to clip onto an adjustable
mechanical arm adjacent the oral cavity.
* * * * *